The drug "Dysport" in volumetric facial modeling

Indications

1. Elimination of facial wrinkles in the eye area.

Once certain units are pricked, the crow's feet disappear. This procedure is usually used by people with active facial expressions. Very often these are wrinkles that appear in people at an early age.

1. Correction of facial folds on the forehead. During the procedure, longitudinal forehead wrinkles are removed. The older a person gets, the deeper they are located along the entire forehead in separate grooves. Such a correction is indispensable for those whose habit is to wrinkle their forehead.
2. Corrective work on the oval of the face. For some, it is associated with bruxism (night clenching or grinding of teeth). Hypertonicity of the muscles does its job, and the lower part of the jaw takes on the appearance of a square, increasing in volume. Dysport will relax the muscular system and soften the facial contours as much as possible.
3. Correction of nasolabial folds. These creases appear at the age of 40-45 years. In general, the injection serves as an appendage to the filler. Botulinum toxin relaxes muscle tissue, and hyaluronic filler plumps and reduces wrinkles.
4. Using Dysport on the glabellar folds. This procedure is the main salvation for those who constantly frown.
5. Dysport injection is used medically for:

• treatment of eye diseases;
• correction of muscle tone;
• hyperhidrosis (fight against sweating of armpits, palms, feet).

In what cases will Dysport injections into the neck area be relevant?

Dysport (neck) is recommended for use in the following cases:

• for smoothing horizontal and vertical wrinkles, folds and even deep creases in the skin, improving the contours of the neck;
• to eliminate protruding strands (the so-called “turkey neck effect”)
• for the treatment of spastic and rotational torticollis.

The dosage of the drug depends on the final goal and is calculated by the doctor during consultation after examination and clarification of your wishes. The smallest dosage of Dysport “for the neck” will be relevant in cases where you need to remove wrinkles and folds. If treatment of torticollis is required, the total injection dosage per procedure can reach up to 500 units. There is no need to be afraid of the effects of botulinum toxin - in Dysport/Botox, the active component acts locally and does not pose any threat to health or life, even theoretically.

Contraindications

There are a number of restrictions on the use of class A botulinum. An experienced doctor will definitely warn that such an injection can cause harm to a person. It should be said that restrictions can be temporary or permanent.

1.The first include:

• pregnancy and breastfeeding;
• various infectious diseases;
• therapeutic use of antibiotics and other groups of drugs.

1. The second half of the restriction includes:

• an allergic reaction to the active composition, when deciding to perform a “beauty injection” you must warn the doctor about your illness and intolerance to drugs with a protein component;
• diseases related to blood clotting - leukemia, hemophilia, etc.;
• difficulty swallowing.

The action of toxic substances can lead to:

• to respiratory arrest;
• endocrine diseases;
• myopia;
• disorders of the neuromuscular impulse, for example, bulbospinal palsy, etc.

Navigation:

• More details
• In which cases
• What else is important

Dysport is officially registered and certified in Russia, that is, its use is absolutely legal. It is only important that the specialist whom you trust to give Dysport injections has the appropriate qualifications and knows how to calculate the dose, dilute the drug and administer it where needed and how much is needed.

Among the advantages of Dysport are the ability to self-remove from the body, harmlessness to the body, minimal likelihood of side effects (provided that a good cosmetologist works).

Drug administration zones and number of units for each zone

The composition is mainly injected into the upper part of the face. The dose at one time is no more than 200 units.

Reviews from patients and opinions of doctors

Almost 70% of women are very satisfied with the results of the procedure and are ready to repeat it again, 20% note a short-term effect, namely the appearance of wrinkles 1.5 months after the administration of the drug, 7% believe that before the procedure they had a nicer facial expression and dream of a speedy return to natural facial expressions, 3% note side effects in the form of headaches, bruises, and swelling.

Judging by the reviews, in the first time after the procedure, girls who have had injections in the mouth experience particular discomfort. According to them, unpleasant sensations occur when chewing food, talking, even when taking deep breaths and exhales.

Doctors say that Dysport was originally used to treat cerebral palsy and spasmodic torticollis, so its toxic effect is very high. The drug, more often than other “brothers” based on botulinum toxin A, is fraught with hidden dangers in the form of migration to muscles adjacent to the injection area and facial asymmetry.

That is why experts advise that if injections are given, then only in the forehead area and between the eyebrows, where in the event of potential migration of the drug, the consequences will not be as dire as in other areas of the face.

Side effects

To avoid any problems later, you should definitely contact a specialized clinic, a specialist with the appropriate qualifications. Only he will be able to calculate how many units of Dysport are needed.

An incorrectly designated injection site, an incorrectly selected dosage, or failure to comply with sterility and hygiene instructions can lead to unpleasant side effects that are difficult to correct.

These include:

• allergic reactions;
• migraine condition;
• anemia, pain at injection sites;
• swelling and drooping eyelids;
• flu-like symptoms;
• DP infection, etc.

How to reduce the effects of Dysport

The cosmetologist also knows how to neutralize the effect of Dysport if neighboring areas are affected, through electrophoresis with novocaine. By contacting the “OB clinic” salon, each person can make an appointment with a doctor for a consultation to receive all the answers to all his questions. In case of severe manifestations of an allergic reaction, namely swelling, it is necessary to consult a doctor to obtain special antihistamines. Sometimes drugs can cause increased dryness of the nasopharynx, as well as dry eyes. In Moscow, every woman will be able to find out how quickly Dysport is eliminated.

Choice of drug

To choose the right medicine, you need to have complete information about it. On the Russian market, highly purified botulinum toxin type A is mainly represented by IPSEN PHARMA (France), USA, etc.

The main characteristics are:

• Compound. Botulinum A toxin has a muscle relaxant effect.
• According to FDA tests and patient reviews, this product is practically safe.
• Efficiency. Not only the main muscles are involved, but also neighboring muscles, the result is visible within 2-5 days.
• Be sure to pay attention to the indications and restrictions.
• The result of the injection.
• The result of the work performed.
• Shelf life and packaging. Usually the amount of drug in bottles is 300-500 units.

Upper third of the face

Selective tactics for correcting the upper third of the face are determined by the characteristics of this zone, which include:

• low forehead;
• pronounced brow ridges;
• low eyebrows;
• horizontal wrinkle and fold on the bridge of the nose;
• a constitutionally determined volumetric shape of the fixed portion of the upper eyelid, protruding and, over time, overhanging the movable portion of the upper eyelid;
• slight gravitational ptosis of the upper eyelids (remember that significant excess skin in all areas, and especially in the periorbital area, is a contraindication to botulinum toxin therapy);
• hernia of the upper and/or lower eyelid;
• tendency to swelling or pastiness of the lower eyelids (the presence of swelling is a contraindication to the use of botulinum toxin!).

It should be emphasized that plastic surgery in any area of ​​the face (and in the upper third, among others) significantly changes the relative position of the muscles, therefore, in such patients, botulinum therapy may have an unpredictable outcome, and the advisability of its use should be discussed with a plastic surgeon.

Work tactics

1. Low forehead. General setting: to avoid eyebrow drooping, it is preferable to minimally limit the mobility of m. frontalis, and sometimes completely eliminate its denervation. Let us repeat, layer by layer, the anatomy of the area located in the projection of the heads of the eyebrows, along the upper orbital edge: the deepest muscles adjacent to the bone are the medial sections of the corrugators; above them the middle layer is the frontalis muscle; then the superficial layer is the terminal fibers of the superomedial portion of the orbicularis oculi muscle. That is why, when treating the labella muscles, the accuracy of Dysport injections deep into the corrugator muscles, directly above which the fibers of the frontal muscle are located, is extremely important; denervation of the latter is extremely undesirable, because they are the ones who “hold” the heads of the eyebrows.

1a. Low forehead and straight eyebrows (especially in combination with low eyebrows). Aesthetically, it is more expedient to at least partially preserve the activity of the frontal muscle and/or limit the work to the glabellar region. In this way, it is possible not only to immobilize the muscles of the bridge of the nose and between the eyebrows, but also, thanks to the slight diffusion of the drug from the glabellar region into the adjacent central region of the forehead, to gently limit the mobility of the muscles of the central part of the forehead. At the same time, the height of the eyebrows is maintained and non-surgical lifting of the midlateral areas of the eyebrows is achieved. The lifting effect after “Dysport” is realized due to the preserved, and in many cases compensatory, increasing in the lateral portions of the contractile activity of the only levator of the upper third of the face—the frontal belly of the occipitofrontal muscle—venterfrontalism. Occipitofrontalis or simply m. frontalis.

The effect of eyebrow lifting can be supplemented (how often we hear this wish from patients!) with intradermal injections of 4-6 units of Dysport into the upper portions of the orbicularis oculi muscles on each side. The target is precisely the upper portion of m. orbicularisoculi, located directly under the eyebrow (“under” not vertically, but in the sagittal plane). These are the most superficial in this area, intradermally intertwined fibers of m. orbicularisoculi. Being a sphincter, which in its upper portion contracts vertically from top to bottom, m. Orbicularisoculi is an antagonist of m. frontalis. Injections of “Dysport” (according to the technique proposed by F. Levi (LeviF.)) are carried out strictly intradermally, directly along the growth line of the eyebrows, both in their caudal segments and in the area of ​​the heads (Fig. 4–5). We avoid the central area of ​​the eyebrow (Fig. 6), in the projection of the pupillary vertical, above the levator of the upper eyelid. Despite its very deep location, it is better to eliminate the risk of ptosis of the upper eyelid as much as possible. Let us once again list all the risks associated with deep injection of botulinum toxin in the area of ​​the brow ridges and associated with the introduction of the toxin into the anatomical formations under the orbicularis oculi muscle:

• denervation of the lacrimal gland and, as a consequence, dry keratoconjunctivitis - with the introduction of botulinum toxin type A into the caudal areas of the eyebrows;
• denervation of the levator muscle of the upper eyelid and, as a consequence, ptosis of the upper eyelid (given the maladaptive nature of this side effect, we avoid injecting the central area of ​​the eyebrows even in superficial techniques) - when injecting BTA in the central areas of the eyebrows;
• denervation of the frontal muscle and, as a consequence, ptosis of the eyebrows - with the introduction of BTA along the entire length of the eyebrows.

Thus, correction of facial wrinkles around the eyes, carried out taking into account the topographic anatomy of the muscles of the upper third of the face, helps to avoid side effects and achieve a smooth bend and lifting of the eyebrows, which makes the look more open and the face attractive. Isolated treatment of the glabella has some delayed effects associated with compensatory activation of untreated areas of the frontal belly of the occipitofrontal muscle -m. frontalis. Thus, after several botulinum therapy procedures, the remaining mobility of the caudal parts of the eyebrows leads to the formation of horizontal wrinkles above them. These compensatory wrinkles form directly above the eyebrows, and therefore it is incorrect to treat them using the classical intramuscular technique. In this case, the mesodisport technique is used - subcutaneous microinjections of microdoses of botulinum toxin. To balance the vector interactions of the antagonist muscles, it is advisable to simultaneously administer 2-4 units of Dysport superficially when correcting facial wrinkles around the eyes using the above technique, taking all precautions and not closer than 1 cm to the bony edge of the orbit.

1b. Low forehead and curved eyebrows (especially when they are low). Here the tactics are somewhat different. Isolated treatment of the glabella and bridge of the nose, as discussed above, can result in the formation of an excessively arched brow (“Mephistophelian brow”) and a rigid, tense facial expression. An additional injection of 2–4 units of Dysport on each side, in the projection of the highest point of the eyebrow (2–3 cm above the eyebrow line), easily corrects this effect.

2. Between the eyebrows and the bridge of the nose. When working with the eyebrows and bridge of the nose, one should not forget about the nasal muscle, since it can be treated either in isolation from the glabellar muscles or together with it to improve the result in the glabellar region. It is injected both prophylactically and when the patient has so-called “rabbit wrinkles.” The fan of wrinkles on the lateral surfaces of the nose, which forms due to the habit of wrinkling the nose while laughing, also requires correction due to the synergy of the nasal muscle with m. procerus, m. Depressor supercilii and m. Corrugator supercilii. Therefore, the nasal muscle is often involved in frowning, especially in the formation of a horizontal wrinkle on the bridge of the nose.

2a. Working with the eyebrow and bridge of the nose in the presence of upper eyelid hernias can lead to an increase in the problem: limited contractility of the muscular surroundings causes a decrease in drainage of the periorbital area and contouring of hydrophilic fatty hernias.

3. Horseshoe-shaped wrinkles that go around the head of the eyebrow from below indicate the activity of m.depressorsupercilii - a synergist. Orbicularisoculi, m. procerus иm. corrugators supercilii. The antagonist of this muscle group is the frontal muscle, so the decision to inject Dysport (botulism toxin) into the forehead in the presence of even small hernias or emerging gravitational ptosis of the upper eyelids should be made responsibly and carefully, with the consent of the patient.

It is very effective to introduce 2 units of “Dysport” (in a dilution of 1 bottle of no more than 2.5 ml) into each depressor, directly under the wrinkle, superficially, subcutaneously, no closer than 1 cm to the bony edge of the orbit. In this case, joint treatment (Dysport injections) m. procerus иm. Corrugator supercilii, but treatment of the central region of the frontal muscle is extremely undesirable (Fig. 7).

4. Constitutionally volumetric shape of the fixed area of ​​the upper eyelid. Often, even at a young age, when gravitational tissue ptosis is practically absent, this feature is a good reason for careful work with the frontal muscle. The management of such patients is controversial. Some experts believe that working with the forehead with such anatomy of the upper eyelid must begin early, since a soft V-shaped treatment of the forehead and the antagonist of the frontalis muscle - the orbicularis oculi muscle in its lateral fraction - makes it possible to achieve lifting of the caudal segment of the eyebrow and maintain an “open look” in such patients. Others, on the contrary, believe that early tactics will lead to compensatory hyperactivity of the lateral areas of the frontal muscle, and after Dysport, the formation of horizontal wrinkles over the lateral areas of the eyebrows is possible. Therefore, it is obvious that individual patient management tactics, in particular the correction of facial wrinkles around the eyes, should be developed taking into account the synergistic and antagonistic components of his facial stereotype, motivation and rate of formation of compensatory wrinkles.

5. A horizontal wrinkle and/or a horizontal fold on the bridge of the nose are aesthetic contraindications for denervation of the frontal muscle. At the same time, working with the bridge of the nose and between the eyebrows with maximum treatment of m. procerus is shown to be extremely effective for the treatment and prevention of gravitational ptosis of the upper third of the face. This is another example when the doctor must prefer one or another aesthetic component and discuss with the patient whether he is ready to deal with the prevention of tissue ptosis, but with the preservation and, possibly, some deterioration of the relief of horizontal wrinkles on the forehead.

6. Pastosity, swelling of the lower eyelids. Considering the connection between the lymphatic drainage system of the face and the cerebrospinal fluid system of the brain, in case of pastosity of the lower eyelids, it is advisable to convince the patient of the preference of lymphatic drainage and biorevitalizing procedures in the periorbital area. Transient swelling of the lower eyelids can be treated in this area with microdoses of Dysport using a superficial mesotherapy technique. The patient is given a recommendation to monitor the water-salt regime in the next two to three weeks after Dysport. This is not only the period for achieving the final aesthetic result, but also the period when there is a redistribution of activity between the superficial and deep fibers of the orbicularis oculi muscle. The latter compensate for the function of denervated superficial muscle fibers and effectively restore drainage of the periorbital area.

Recovery period

Due to the fact that therapy does not require a special rehabilitation scheme, you still have to adhere to some points. The effectiveness of the drug mainly depends on the rules that must be followed after administration of botulinum toxin type A.

There are several stages of recovery:

• prohibited actions immediately after the procedure;
• the first 15–20 days after the end of therapy;
• next 2–3 months.

1. You should only be in a horizontal position for at least two hours. This process is necessary to keep the muscles in their natural state while the drug is being absorbed. If this is not done, then the person’s face can turn into an unnatural mask.

You should talk a lot, laugh, grimace and frown. The moving muscle helps the medicine penetrate much deeper into the tissue. You can “make a face” immediately after the procedure for 1/2 hour.

Later, the stage of muscle atrophy occurs; to avoid injury, facial exercises should be reduced.

1. Swelling may be observed at the injection point. This is completely normal during the first weeks after the injection. They are more noticeable on the most delicate skin, that is, under the eyes.

Monitor the amount of liquid you drink, then they will drop to a minimum level. If your metabolism is normal, then you should not break your normal diet. But the best option would be to consult a specialist for advice.

Due to the severe stress in the first weeks, the skin requires special care. You should avoid peeling and scrub, eyebrow counter-current masks and creams.

Baths, saunas and other thermal institutions should be left until good times, since heat activates the removal of dysport from the tissue at the stage of its fixation.

1. The skin will calm down a little and then you can begin a light hardware facial massage and hair removal.

All manipulations must be performed with some caution. For a person injecting Botox or disport, manual massages, myomastimulation, and microcurrent effects are strictly contraindicated.

How is the procedure done?

After a preliminary consultation with the doctor and agreement on the areas in which the injections will be made, the procedure scheme is as follows:

1. the patient’s face is disinfected with Chlorhexidine solution;
2. a marker marks the injection areas and applies the anesthetic;
3. the drug is directly administered;
4. Ice is applied to the face (for approximately 15 minutes).

The entire session takes no more than 20 minutes. The effect is achieved due to the fact that the muscles involved in facial expressions stop receiving nerve impulses to make movements. Thus, they relax, and the wrinkles that formed due to the movement of these muscles smooth out or become less noticeable.

The day before the procedure, you must avoid alcohol, nicotine and coffee. In a few weeks, stop taking antibiotics and anticoagulants.

You should remain calm for 3-4 hours after the session, but you must keep your head upright and it is strictly forbidden to touch the injection area with your hands!

For the next 2-3 days you need to follow these recommendations:

1. exclude visiting the sauna, swimming pool and, in general, any contact of the treated areas with water;
2. do not blow dry your hair;
3. do not wear makeup;
4. avoid physical activity.

For another 2 weeks after the injections, the following are excluded: sauna, swimming pool, solarium and other exposure to ultraviolet rays, as well as alcohol.

What else is important

The active component begins to act immediately after entering the facial muscle. Within a day, changes begin to occur. During the first days, the patient may be bothered by swelling, bruising and redness. These side effects are considered normal and go away quickly.

The result is assessed after approximately two weeks. If the result is “insufficient”, additional correction is possible. It happens that a doctor will play it safe (especially a less experienced one) and administer a smaller dosage than required. There is little pleasure in this, but you shouldn’t be upset: you need to come and “finish” the injections after two weeks.

We would like to emphasize that in our clinic all injection procedures (not only Dysport and Botox injections, but also biorevitalization, mesotherapy, plasma lifting) are carried out by qualified and very experienced specialists. Each patient is guaranteed: selection of injection techniques that are optimal specifically for her, correct dosage, flawless administration of the drug and obtaining the expected result (discussed in consultation with a cosmetologist).

Appointments for consultations are available daily. Call us!